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Dr. Chai: 'It's the whole team that works together'

By Dr. David C. Pate, News and Community
February 14, 2013

We are exceptionally proud of Dr. Andrew Chai of St. Luke’s Idaho Cardiology Associates.

Dr. Chai recently passed an examination and became the only Idaho cardiologist who is board-certified in Advanced Heart Failure and Transplant Cardiology, according to the American Board of Internal Medicine. He has been board-certified in Cardiovascular Disease and Nuclear Cardiology since 1998 and 2000, respectively.

In 1999, Dr. Chai joined Idaho Cardiology Associates, which became part of St. Luke’s five years ago. For the past two years, he has led the Heart Failure Clinic staff with innovations in managing and caring for a population of complex and difficult patients.

The results of the Heart Failure team’s efforts speak for themselves:

  • Readmissions within 30 days of release from the hospital decreased to about 17 percent in 2011-2012 from 24 percent before the clinic started.
  • The percentage of patients receiving all Medicare-required therapies and education has risen to 97 percent in 2011-2012 from 92 percent in 2009-2010.
“It is gratifying and rewarding to have cardiologists like Dr. Chai who continue to strive to improve the patient experience of care and provide improved outcomes through TEAMwork,” said Dr. Marshall Priest, executive medical director of St. Luke’s Heart.

Following is an interview with Dr. Chai. For a story on the Heart Failure Clinic and activities organized around National Heart Failure Awareness Week, click here.

 How has your medical training influenced your life?

“You go to places to train," Dr. Chai said. "I lived in places in the country where I would have never lived because I went to train.”

Dr. Chai graduated from the Medical College of Wisconsin in 1992. He interned in internal medicine at the University of California, Davis, Health System in 1992/1993 and did his residency at the Medical College of Wisconsin from 1993 to 1995.

He achieved a fellowship in cardiology at the University of New Mexico from 1995 to 1998. He is a fellow of the American Society of Nuclear Cardiology and an assistant clinical professor at the University of Washington and Boise VA Medical Center.

He has published a number of papers and worked on more than two-dozen research studies as a principal or sub-investigator.

How did you choose Idaho?

“Dr. Murali Bathina (of Idaho Cardiology Associates) was here," Dr. Chai said. "He and I trained together ... He asked me to come and look at this job.

"We were here sometime in September with our 3-month-old baby. It’s a beautiful time of year," he said. "When we came here, it just felt like home to us. My wife immediately liked it. The people were so nice.”

Dr. Chai, 50, and his wife now have two children.

Idaho Cardiology Associates joined St. Luke’s five years ago. How has that affected your practice?

“It hasn’t really impacted my day-to-day work, but it has made it easier for me to be a physician," Dr. Chai said.

"It allows me to be a doctor instead of be an administrator or a business owner. It has made it more cost-effective, and probably easier access for patients, because there is no separation of practice and hospital. It just allows me to practice medicine in a really patient-centered, conducive environment.”

If you were speaking to a patient, how would you explain the significance of being board-certified?

“No. 1, it tells me [the physicians] have gone through all the prerequisite steps. So they obviously have the credentials that are required to become an expert in the field," he said. "The board certification tells you that this person is dedicated to sustaining their skills and their learning as a lifelong process. They’re continuing to learn and to stay with the changes that happen in medicine today.”

Can you give an example of innovation?

“Just the establishment of the Heart Failure Clinic – that again would not have been possible if we were not a part of St. Luke’s," Dr. Chai said.

"The integration of the practice into the system has really helped that," he said. "... We got the heart failure coordinators. ... They were instrumental in the coordination of the inpatient care. They developed a program to educate the patients, their families and the staff regarding heart failure. They also brought a level of organization to that so that they can ensure that the patients were getting the right care and we were meeting core measures.

"But then once these people left the hospital, we didn’t know where they went," Dr. Chai said. "The outpatient Heart Failure Clinic came on, andfilled that void.  Now there was a clinic where these patients could be seen in a timely fashion.  This allowed us to identify and treat patients

Any other innovations?

“Development of a relationship with Intermountain Medical Center in Salt Lake City," Dr. Chai said. "They are a transplant and advance heart failure center. It gives us access and a close working relationship with a cardiac transplant and LVAD (left ventricular assist device) center.  Not only can they help us with these procedures, but their specialists also come to the Treasure Valley to see these patients in our clinic.  This makes it much easier for the patients and their families. It’s all those things together that’s really helped the care process. It’s just assembling the team.  It’s the whole team that works together ...

“I would be remiss if I didn’t mention Linda Mikitish, nurse navigator," he said. "She’s actually going to the patients’ homes, educating them, going through their cupboards and telling them what’s good and bad for them, and how to avoid sodium in their diets, and how to be heart healthy from a heart failure standpoint and checking in on them ... It’s the coordination of care that’s been important. That’s why we’ve had success.”

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.

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